Surgery After Significant Weight Loss
Losing 100 pounds or more is a major achievement. But once you’ve reached your goal, you might find that your new healthier, thinner body needs some additional fine-tuning. That’s because large amounts of excess skin that have been stretched around the abdomen, arms, legs, breasts and face may have lost its elasticity. After significant weight loss, the skin often fails to shrink back to its former size and shape.
Plastic surgeons at Cleveland Clinic Cosmetic & Plastic Surgery Center offer body contouring surgery designed specifically for patients who have achieved significant weight loss. Procedures that remove skin or fat, tighten and lift can be used as a complement to help your clothes fit better and allow you to participate more comfortably in your favorite activities.
Am I candidate for surgery after significant weight loss?
The best way to determine if you are a candidate for surgery after significant weight loss is through a thorough consultation with a plastic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center.
The most successful outcomes from body contouring surgery are achieved when these important criteria are met:
- Weight trend:
- Has your weight been stable for at least a year with no further weight loss expected?
- Overall good health:
- Are you in good health overall? Do you have any chronic medical conditions, such as diabetes or heart disease? People in poor health are not good candidates for body contouring procedures. You should carefully review your health with a doctor at Cleveland Clinic Cosmetic & Plastic Surgery Center before proceeding with surgery.
- Do you have a healthy diet? Problems such as protein or vitamin deficiencies can interfere with healing after surgery.
- Smoking history:
- Smoking slows down the healing process and increases the risk of serious complications during and after surgery. You will be instructed to quit smoking at least six weeks prior to surgery.
Individuals with a positive outlook and realistic goals for what body contouring can accomplish are also good candidates for body contouring procedures.
How do I prepare for surgery after significant weight loss?
Preparing for surgery after significant weight loss at Cleveland Clinic Cosmetic & Plastic Surgery Center includes discussing a number of questions about your health, desires and lifestyle with your plastic surgeon, including:
- Why you want the treatment(s), your expectations and desired outcome
- Your medical conditions, drug allergies and medical treatments
- Your use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
Your Cleveland Clinic plastic surgeon may also:
- Evaluate your general health and any pre-existing health conditions or risk factors
- Take photos of your body for your medical record
- Discuss your body contouring treatment options
- Discuss likely expected outcomes of body contouring treatment and risks or potential complications.
How is surgery after significant weight loss performed?
There are a variety of body contouring procedures that can treat your needs after significant weight loss. Your plastic surgeon will work with you to identify areas that are the most problematic or bothersome to you.
The areas of the body that are most often treated through body contouring after significant weight loss include:
Also known as a "tummy tuck," abdominoplasty involves removing excess skin and tightening of the underlying abdominal muscles. An incision is made just above the pubic area from hip to hip, occasionally extending to the back. Sometimes a vertical incision is necessary, too.
A panniculectomy removes any overhanging “apron” of skin and tissue from below the belly button. Having the abdominal muscles tightened or extending the incision to the back is most often considered cosmetic and is not usually covered by insurance.
At times, an abdominal hernia may be found. Hernias up to a certain size can be repaired at the same time of the removal of excess abdominal skin. However, your plastic surgeon may refer you to a general surgeon if the hernia is too large to be repaired during the abdominal procedure.
A body lift, or belt lipectomy, is a procedure to remove skin and lift the thighs and buttocks. This is usually performed as a continuation of an abdominal procedure. The incision is made in the belt area in the upper hips and excess skin is removed below the incision.
A medial thigh lift, designed to remove excess skin from the upper leg, involves an incision along the inner thigh starting at the groin and extending as far as the knee.
A number of breast procedures are available, including breast lift with or without augmentation (enlargement with implants) and breast reduction. To remove excess skin, incisions can be made vertically down the center of the breast. Sometimes incisions are made underneath the breast in the form of an upside-down "T."
During surgery to remove excess skin from the arms (brachioplasty), an incision is made starting at the armpit and extending to the elbow. Sometimes this procedure can be combined with a breast procedure.
Face and neck
Removing excess skin around the face or neck after weight loss is similar to a traditional facelift, except that more skin is removed. As a result, incision location may need to be altered.
A combination of body contouring surgeries may be done at the same time, as long as safety can be maintained. An "upper body lift" may include a combination of surgeries to the arms, back, and breasts/chest.
A "lower body lift" may include combination surgeries to the hips, thighs, abdomen, and buttocks. The exact procedures to be performed at one time will be individualized to your needs through a thorough consultation with a plastic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center.
What results can I expect?
The results of body contouring surgery after significant weight loss are visible almost immediately. However, it may take as many as one to two years or more for the final results of all the recommended body contouring procedures to fully develop. Visible scars from surgery will remain, but the overall results are long lasting if you maintain a stable weight and general, overall fitness.
As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent. Follow-up with an expert at Cleveland Clinic Cosmetic & Plastic Surgery Center is the best way to ensure long-lasting results from your body contouring procedures.
What is involved in recovery?
Following your body contouring procedure(s) after significant weight loss, dressings or bandages will be applied to the incisions. A small, thin tube (drain) may be temporarily placed under the skin to drain any excess blood or fluid that may collect. The number of drains used may vary depending on the procedure.
Body contouring surgeries may be performed as an outpatient procedure or require an overnight stay or longer depending on the procedure.
Your post-surgery activities will be restricted until you have had plenty of time to recover. Restrictions may include no exercise and lifting of five pound or more. Walking is encouraged after surgery; however, additional exercise is not recommended until you’ve fully healed.
A certain degree of soreness, swelling and bruising for two to three weeks after surgery is normal. Most people can return to work after two to four weeks, but people with physically demanding jobs need to wait at least three weeks. During this recovery period, you will monitored regularly by your plastic surgeon to ensure the best results.
Is surgery after significant weight loss safe?
Possible risks of body contouring surgery following significant weight loss include:
- Unfavorable scarring
- Bleeding (hematoma)
- Fluid accumulation
- Poor wound healing
- Skin loss
- Numbness or other changes in skin sensation
- Anesthesia risks
- Skin discoloration and/or prolonged swelling
- Fatty tissue found deep in the skin might die (fat necrosis)
- Major wound separation
- Recurrent looseness of skin
- Pain, which may persist
- Deep vein thrombosis, cardiac and pulmonary complications
- Persistent swelling in the legs
- Possibility of revisional surgery
Why Choose Us
If you’re considering body contouring surgery after significant weight loss, look for a plastic surgeon with specialized training and significant experience performing these procedures. Consider going to a plastic surgeon who is affiliated with a major medical center, such as Cleveland Clinic. Ask your specialist about credentials, training and how many body contouring surgeries he or she has managed.
Is this procedure covered by health insurance?
Like all cosmetic procedures, body contouring surgery after significant weight loss is not typically covered by health insurance. Ask to talk with a financial representative from Cleveland Clinic Cosmetic & Plastic Surgery Center who can explain the cost of the procedures and if insurance coverage is an option for you.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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